Provider Demographics
NPI:1790540565
Name:NEW ENGLAND PSYCHIATRY AND WELLNESS LLC
Entity Type:Organization
Organization Name:NEW ENGLAND PSYCHIATRY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JOHANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CACIO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:603-616-5906
Mailing Address - Street 1:1353 ROUTE 117
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:NH
Mailing Address - Zip Code:03586-4214
Mailing Address - Country:US
Mailing Address - Phone:603-616-5906
Mailing Address - Fax:
Practice Address - Street 1:461 MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANCONIA
Practice Address - State:NH
Practice Address - Zip Code:03580-4835
Practice Address - Country:US
Practice Address - Phone:603-616-5906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health